Validation of the Lewis score for the evaluation of small-bowel Crohn’s disease activity

Cotter, José; Castro, Francisca Dias de; Magalhães, Joana; Moreira, Maria João; Rosa, Bruno

doi:10.1055/s-0034-1390894

Cited by 51 publications

(50 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The longterm clinical significance of mild SBI in patients with SpA is unclear. LS of 135 was initially proposed as a cutoff value in patients with clinical suspicion of IBD 47 . However, mild small bowel lesions can be detected frequently in healthy controls or in NSAID users 26 .…”

Section: Kopylov Et Al: the Space Capsule Studymentioning

confidence: 99%

Detection of Crohn Disease in Patients with Spondyloarthropathy: The SpACE Capsule Study

Kopylov

Starr²,

Watts³

et al. 2018

J Rheumatol

View full text Add to dashboard Cite

Objective.Inflammatory bowel disease (IBD) is generally reported to be associated with spondylarthropathies (SpA) in 5%–15% of cases. Systematic colonoscopic assessment by protocol demonstrated mucosal inflammation characteristic of Crohn disease (CD) in up to one-third of patients with SpA. Video capsule endoscopy (CE) is a superior diagnostic tool to detect small bowel mucosal disease. Our study compared the accuracy of CE to standard colonoscopy for detection of inflammatory bowel lesions in patients with SpA, and to describe predictors of small bowel inflammation (SBI) in this cohort.Methods.Prospective cross-sectional study of adult patients followed for SpA. Patients were evaluated by CE and standard colonoscopy with biopsies. SBI was quantified using the Lewis Score. Additional screening tests included fecal calprotectin (FCP), C-reactive protein (CRP), and a diagnostic panel of serologic, inflammatory and genetic tests (SGI).Results.There were 64 patients recruited (53% female, mean age 42 ± 13 yrs). Chronic gastrointestinal (GI) symptoms were present in 57%. CE revealed significant SBI in 27/64 (42.2%), compared to 7/64 (10.9%) by standard colonoscopy (p = 0.035). Elevated FCP was associated with small bowel CD (OR 4.5, 95% CI 1.01–19.9; p = 0.042). No correlation was observed with presence of GI symptoms, CRP, or SGI results. Finding CD led to a change in management in 65.2% of cases.Conclusion.CE uncovered SBI consistent with CD in 42.2% of patients with SpA, with a significant incremental yield over colonoscopy of 31%. FCP levels were significantly correlated with CE results, while GI symptoms and SGI results were poor predictors of SBI.

show abstract

Section: Kopylov Et Al: the Space Capsule Studymentioning

confidence: 99%

Detection of Crohn Disease in Patients with Spondyloarthropathy: The SpACE Capsule Study

Kopylov

Starr²,

Watts³

et al. 2018

J Rheumatol

View full text Add to dashboard Cite

show abstract

“…1 and 2). When any of these inflammatory lesions were seen we used the Lewis Score (LS) to assess severity: normal mucosa or non-significant inflammation, LS < 135; mild-moderate inflammation, LS: 135-790; severe mucosal affectation, LS > 790 (10,11).…”

Section: Classification Of Ce Findingsmentioning

confidence: 99%

Fecal calprotectin and C-reactive protein are associated with positive findings in capsule endoscopy in suspected small bowel Crohns disease

Valenzuela¹,

López²,

Fernández³

et al. 2016

Rev Esp Enferm Dig

View full text Add to dashboard Cite

Background and aims:Capsule endoscopy is an extended tool for the diagnosis of small bowel Crohn's disease. However, factors associated with positive findings of this technique have not been well established. Our aim is to asses which factors are associated with a better diagnostic yield of capsule endoscopy in suspected small bowel Crohn's disease.Material and methods: This was a retrospective study including patients under capsule endoscopy because of suspected small bowel Crohn's disease. Demographic data of these patients, as well as symptoms and laboratory data including hemoglobin levels, count of leucocytes and platelets, and levels of C-reactive protein, erythrocyte sedimentation rate and fecal calprotectin were collected. Capsule endoscopy studies were classified as negative (no lesions) or positive (lesions suggestive of Crohn's disease). Descriptive, univariate and multivariate analysis were done, as well as diagnostic yield tests of the different markers for predicting lesions in capsule studies.Results: One hundred and twenty-four patients were included (85 women and 39 men). The average age was 38.21 years. Levels of C-reactive protein and fecal calprotectin were the markers more frequently associated with positive findings in capsule endoscopy. Calprotectin presented the best sensitivity as isolated marker. The association of altered levels of C-reactive protein and calprotectin showed the best specificity and predictive values.Conclusions: C-reactive protein and fecal calprotectin are appropriate biomarkers for selecting patients with suspected Crohn's disease of the small bowel for capsule endoscopy studies.

show abstract

“…Villous edema is a particularly important finding in this setting, since its characteristics and distribution are part of a validated inflammation score, the Lewis score (16). This is available in the PillCam® capsule reading software (RAPID®).…”

Section: Discussionmentioning

confidence: 99%

Capsule endoscopy with PillCamSB2 versus PillCamSB3: has the improvement in technology resulted in a step forward?

et al. 2017

Self Cite

View full text Add to dashboard Cite

Aim:To compare the findings and completion rate of PillCam® SB2 and SB3.Methods: This was a retrospective single-center study that included 357 consecutive small bowel capsule endoscopies (SBCE), 173 SB2 and 184 SB3. The data collected included age, gender, capsule type (PillCam® SB2 or SB3), quality of bowel preparation, completion of the examination, gastric and small bowel transit time, small bowel findings, findings in segments other than the small bowel and the detection of specific anatomical markers, such as the Z line and papilla. Conclusions: Overall, PillCam® SB3 did not improve the diagnostic yield compared to SB2, although it improved the detection of villous atrophy and segmental edema. Results

show abstract

Validation of the Lewis score for the evaluation of small-bowel Crohn’s disease activity

Cited by 51 publications

References 25 publications

Detection of Crohn Disease in Patients with Spondyloarthropathy: The SpACE Capsule Study

Detection of Crohn Disease in Patients with Spondyloarthropathy: The SpACE Capsule Study

Fecal calprotectin and C-reactive protein are associated with positive findings in capsule endoscopy in suspected small bowel Crohns disease

Capsule endoscopy with PillCamSB2 versus PillCamSB3: has the improvement in technology resulted in a step forward?

Contact Info

Product

Resources

About

Validation of the Lewis score for the evaluation of small-bowel Crohn’s disease activity

Cited by 51 publications

References 25 publications

Detection of Crohn Disease in Patients with Spondyloarthropathy: The SpACE Capsule Study

Detection of Crohn Disease in Patients with Spondyloarthropathy: The SpACE Capsule Study

Fecal calprotectin and C-reactive protein are associated with positive findings in capsule endoscopy in suspected small bowel Crohns disease

Capsule endoscopy with PillCamSB2 versus PillCamSB3: has the improvement in technology resulted in a step forward?

Contact Info

Product

Resources

About

Fecal calprotectin and C-reactive protein are associated with positive findings in capsule endoscopy in suspected small bowel Crohns disease